August 13, 2009

http://www4.smsd.org/autism

Presented by Kathy Brodie and Amy Quinley, Autism Specialists

Para training for working with students with Autism Spectrum

Disorders

Autism Spectrum Disorders(ASD)

Neuro-biological disorder that affects the functioning of the brain, impacting social interactions and communications skills development

The impact is with varying degrees of severity

The one feature that differentiates ASD from other syndromes is the limited or lack of ability to socially interact with others (Firth, 1989)

Diagnosis is based on the presence or absence of specific behaviors – diagnosis is by observation only

Children are born with the disorder or the potential to develop it

There is no cureChildren do not outgrow ASDAppropriate, consistent interventions

help to lessen the impact of the deficits of the disability

CausesASD is caused by either structural

anomalies or disturbances in sections of the brain

Researchers are investigating a number of causes of ASD◦The brain structure is different in

children on the spectrum A link between heredity, genetics and

medical problems A “trigger” has not yet been identified

Prevalence1 in 150 births (CDC, 2007)Affecting as many as 1.5 million Americans

ASD (Autism Spectrum Disorder) and PDD (Pervasive Developmental Disorder) are synonymous.

The spectrum includes◦ Autistic Disorder◦ Aspergers Syndrome◦ PDD-NOS◦ Rett’s Disorder◦ Childhood Disintegrative Disorder

Underlying Characteristics

Patterns of behavior need to be assessed with an understanding of the underlying characteristics of ASD

Understanding the underlying characteristics helps to determine the appropriate intervention

Underlying characteristics are exhibited in the following areas:◦ Social◦ Restricted patterns of behavior, interests, activities◦ Communication◦ Sensory differences◦ Cognitive differences◦ Motor differences◦ Emotional vulnerability

ASD – Educational ASD – Educational ConcernsConcerns

Rote (and usually visual) learnersOften off task due to distraction from

internal/external stimuliDifficulty with organizationDifficulty working cooperatively with othersDifficulty understanding abstract conceptsRote or pedantic speech may give a false

impression of comprehensionFine motor difficultiesDifficulties with problem solvingMay be physically clumsy and awkward

ASD – Communication Concerns

Rote communication skillsDifficulty with abstract conceptsDifficulty with non-verbal cues and

nuancesTopic perseverationLiteralnessDifficulty in pragmatic use of languageMay make irrelevant commentsTendency to interrupt or talk overMay demonstrate an advanced vocabulary

ASD – Behavioral Concerns

May be rigid, extreme rule followers and enforcers

Difficulty with problem solving – may use only one method for solving or reacting to a situation

Difficulty with transitions◦ Between locations; between activities; between

steps of an activityMay need to adhere to specific routines and

ritualsMay appear non-compliant due to lack of

social understandingPreoccupation with narrow areas of interest

What you might see as a result of behavioral concerns:◦ Refusal to cooperate◦ Arguing◦ Elevated voice pitch and volume◦ Yelling◦ Meltdowns◦ Aggressive acts

ASD – Social Interaction Concerns

Mindblindness◦ Difficulties in both the use and

understanding of nonverbal behaviors◦ Inability to understand and utilize the

unwritten rules of social conduct Difficulty playing with othersNaïve and easily influencedMay appear rudeMay not understand jokesDifficulty working in proximity to peers

What you might see as a result of social concerns◦ Poor academic performance◦ Peer failure◦ Rejection◦ Isolation◦ Anxiety◦ Depression◦ Substance Abuse◦ Suicidal Ideation

Scott Bellini (2007)

Why Social Skills?Even those children on the spectrum who

speak well and are high achievers in school, are at high risk for failure in life.

One study conducted of adults with Asperger Syndrome showed the following results:◦ 88% were unemployed◦ 3% could live independently◦ 65% had no social contact outside of their

family◦ None were married or involved in a significant

emotional relationship

National Autism Society of Great Britain (2001)

Understand the importance of social skills to future success – work with the team to provide specific social skill intervention for students

Capitalize on “teachable” momentsRemember, it’s the process, not the

productAssign students alternative roles in

group settings, capitalizing on strengths – it may be necessary to be creative in designing their roles

Interventions for success

Don’t ask, tellFollow throughWaitMore is not betterParaphrase using similar languageKeep statements short and to the pointAvoid use of abstract language (i.e.,

metaphors, idioms, puns)Alert student’s attention with phrases

like “This is important, listen carefully” or “Be sure to write this down” or sound an audible cue before announcing directions

Avoid large amounts of written workSet realistic and mutually agreed upon

expectations for neatnessAvoid pressures of speed and accuracyProvide fill in the blank sheets with

page numbers to locate answersSubstitute projects for written workProvide word banks when appropriate

Teach concrete concepts prior to teaching abstract concepts

Reduce number of concepts introduced at any one time

Highlight important concepts to be learned in text or material

List steps (i.e., steps in mathematical process or experiment) so student knows exactly what to do – the visual support will be helpful

Present a study guide that includes only the information that will be tested – eliminate extraneous material

The underlying characteristics for successful interventions

Be flexibleBe consistent across environments Keep your sense of humorDon’t personalize situationsBe able to “Think Outside the Box”

Behavioral Supports

5 Point ScaleComic Strips

Written ExpectationsPower Cards

Silence is Golden

Reinforcement strategies must be applied consistently across environments◦Keep in mind that students with ASD may

not respond to typical reinforcers or to typical reinforcement schedules

◦Also, students with ASD may not always respond to typical consequences

Model behaviors you wish to teach – remember – you are modeling the entire day.

Make directions and expectations clear – communicate expectations to the student

Don’t engage in arguing with students

The Incredible 5 Point Scale Supports social understanding. Can be used for a variety of situations (i.e., voice level, frustration,

touching others, etc.). Colors and numbers give the students a quick and visual way to

reference how they feel and what they should be doing.

54321

Comic StripsDrawings on a white board, or on

a notebookUse for detailing situations that

may otherwise be difficult to hash out◦A problem at recess or lunch◦How to handle a bully◦The steps to a math problem

Written ExpectationsWhen it’s in writing, there is less

to sort through.Provide simple and short

directions.Just the facts… that’s all you

need.Can be done on the spot – it

doesn’t have to be a fancy, color enhanced, laminated ordeal.

Power CardsUse highly motivating

characters/people to teach:◦Perspective taking◦Social skills◦Rules◦Expectations◦Choices◦Generalization

The M & M crew has great school behaviors!

Blue M & M always remembers to:

Sit in his seat.

Follow directions given by grown ups.

Let the grown up be in charge.

When I am at school, I will act like part of the M & M crew and I will have great school behaviors!!!

Remember……Maximize visual supports.Minimize verbal prompts.Allow sufficient wait time.

Silence is Golden